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Health concerns top administration's priority list as Congress scrambles to adjourn

WASHINGTON (CNN) -- The Clinton administration is girding itself for at least two weeks of hard-nosed combat with the Republican-controlled Congress over a host of budgeting and social priorities, specifically a host of health care bills that the president regards as essential.

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White House Chief of Staff John Podesta told a small group of reporters from Internet news organizations that the administration was intent on working in a bipartisan way with the opposition-led House and Senate, but would stand its ground on issues such as prescription drug coverage for Medicare recipients and an HMO patients' bill of rights.

The administration, Podesta implied, is ready to make a good show of this president's last full-fledged battle with Congress.

Speaking to reporters in his White House office Thursday, Podesta presented an image of a White House staff with shirt sleeves rolled up in preparation for the tough work that regularly accompanies the end of a congressional session, and of a Congress whose sights may be set more on Nov. 7, than their projected October adjournment date.

"We ought to get that work done and we ought to do it before the election, so the American people can make a judgment about the quality of that work. I think that it is not in our game plan to come back here after the election to finish up work that should have been done last month," Podesta said.

White House Chief of Staff John Podesta meets with Internet Press Reporters to discuss the President's legislative agenda  

Congress and the administration have one pressing constitutional obligation to dispense with in the course of these next weeks -- the funding of the operations of the federal government for the next fiscal year.

The current year comes to an end at midnight Saturday. With only two of the 13 government appropriations bills signed into law, Congress has approved -- and the president has signed -- a resolution to continue government funding at fiscal 2000 levels into the next week.

Another so-called "continuing resolution" may be needed as the administration negotiates with the congressional leadership on the remaining bills, many of which now exist under the black cloud of a veto threat.

  MESSAGE BOARD
Bill Clinton's legacy
 

Many of those, Podesta said, stand to be wrapped into one "omnibus" bill that is likely to include new tax statutes and other pieces of legislation tacked on as some sort of medium between congressional and administration priorities is hammered out.

"We're frustrated ... The next two weeks will tell for the American people," Podesta said, adding that Congress' hands would be quite full as the administration presses its health care wants and other items on its wish list -- such as a $1-per-hour hike to the national minimum wage.

Drug coverage for seniors

President Clinton's chief of staff spoke at length about the administration's desire to see some form of prescription drug benefit appended to the existing Medicare regime, saying he thought there was still some chance to strike a deal -- though Senate Majority Leader Trent Lott, R-Mississippi, and House Speaker Dennis Hastert, R-Illinois, have insisted there was no time left this year to get anything done.

  MESSAGE BOARD
The cost of medicine
 

"If there's a will to do it, there's certainly a way to do it, and we're going to keep pressing for it. We refuse to give up on it," Podesta said. But the apparent intransigence of congressional GOP leaders, he said, may only be broken if the public puts enough pressure on the legislative branch.

Though Podesta said he was not in the business of "handicapping" the success or failure of a prescription drug benefit, the issue is likely to remain pivotal heading into the general election.

Vice President Al Gore, the Democratic nominee, is championing a prescription drug benefit modeled on that devised by President Clinton and the congressional Democrats.

  RESOURCES
Vice President Al Gore's Medicare plan: "Medicare at a Crossroads" (Adobe pdf, 548K)

Bush's blueprint for the middle class:
'Real Plans for Real People'
Adobe pdf (3.3 MB)
 

That plan would use a large portion of the federal government's budget surplus to add a drug benefit to the traditional fee-for-service brand of Medicare, effectively amending the 1965 statute that established the program.

President Clinton, Podesta said, is fond of saying "If medicine was practiced in 1965 the way it's practiced today, there's no question that prescriptions would have been included in Medicare."

Texas Gov. George W. Bush, the Republican presidential hopeful, has advanced a broad Medicare overhaul plan that includes federal incentives for private insurers to create their own prescription plans for seniors -- much like the legislation the congressional Republicans devised earlier this year.

While the candidates battle over their two plans, the legislation that influenced both languishes in Congress. "It's going to take the public pressure of the American people saying 'we want a benefit, we want a reasonable, decent benefit that's going to be affordable and voluntary, and we want it through Medicare.'"

"The priority is real," he continued. "[It is] whether you believe in Medicare, whether you want to move forward with Medicare, whether you want to modernize Medicare ... or do we want to go off, break apart and deconstruct Medicare and have a scheme that's going to give more incentives to insurance companies."

  MESSAGE BOARD
Election 2000
 

"That may ultimately be decided by this election," he said.

An indication that some in the Senate may be softening their position, Podesta said, is the chamber's willingness to look into a bill that would allow the reimportation of drugs manufactured in the United States for export.

Theoretically, such a move could mean lower prices here for domestically manufactured drugs that routinely cost less to purchase outside the country.

"It's good to see the iron grip of the pharmaceutical industry may finally be breaking on Capitol Hill," he said.

Patients' Bill of Rights

Second on the list of health priorities is the so-called Patients' Bill of Rights, whose various incarnations would give individual medical patients a legal leg up in disputes with their insurance provider or health maintenance organization (HMO).

The battle in Congress -- which falls more on cameral rather than partisan lines -- is over the degree to which individuals with disputes against their HMOs will be able to seek a reversal of an insurer's decision, or redress if denial of treatment leads to injury or death.

  MESSAGE BOARD
Politics of Health Care
 

The holdup, Podesta said, was in the Senate. The upper chamber's version of the bill, which is not as comprehensive as the bill passed in the House and favored by the administration, will not move unless procedural hurdles can be cleared.

The Senate Republican leadership, Podesta said, doesn't want the bill to move, and told the administration as much during a bipartisan budget strategy meeting at the beginning of the month.

Podesta said he was certain of 50 "yes" votes in the 100-seat Senate should the bill come to the floor, but Senate Majority Whip Don Nickles, R-Oklahoma, told him that 50 wouldn't be enough. Sixty would be needed to break down the parliamentary barriers holding the bill up.

"A majority isn't enough; we've got to break a filibuster over there," Podesta said. "That's a sad commentary on the state of where this Congress is."

"We've shown willingness to try to be flexible on some of the issues, but we're going to demand a real patients' bill of rights, not one that leaves out 100 million Americans -- like the Senate version of the bill did -- not one that doesn't guarantee the right to see a specialist, the right to go to the nearest emergency room, the right to have continuity of care, the right to participate in clinical trials, and some adequate enforcement mechanisms," he said.

Podesta thinks some Republican senators who are "vulnerable" as they stand for re-election hold the key to the bill's success in the chamber, saying he believed they would not "abandon their constituents" on the issue.

The president's chief of staff added that the administration was poised to release a new set of medical privacy rules intended to curtail the distribution of individual medical records by insurance companies for profit or for the promotion of prescription drugs that may be used to treat a patient's specific malady.

The guidelines would be disclosed before the end of the calendar year, he said.

Also on the administration's wish list for the end of the 106th Congress: enactment of Medicare and Social Security lockboxes; placement of 100,000 new public school teachers and a initiatives to construct and renovate public schools; and the $1 minimum wage hike.

Should that wage raise become a reality, it would likely have to be accompanied by a set of tax incentives to assuage Republicans who regularly argue that government mandated raises are injurious to small businesses.

 
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